Caasi, Michael Angelo T.

BSN III-IV

Teenage Gastric Bypass Surgery Can Raise Risk Of Having Babies With Defects
With more obese teenage girls undergoing gastric bypass surgery, there is growing concern about a possible increased risk of having babies later on with disabilities, such as mental retardation or paralysis, as a result of damage to their nervous system, researchers explained at the American Academy of Pediatrics National Conference. Specifically, the risk relates to neural tube defects in the brain and spinal cord. Researcher, Diana L. Farmer, MD, explained that neural tube defects can be a consequence of nutritional deficiencies. Dr. Farmer and team reviewed the case of a young female who had undergone gastric bypass surgery, and later became pregnant. As her fetus had spina bifida, she had arrived at the Fetal Treatment Center at UCSF Benioff Children's Hospital to talk about the possibility of fetal surgery. After carrying out a review, the researchers discovered six more documented cases of babies born with neural tube defects which were probably caused by nutritional deficiencies - in all cases their mothers had undergone gastric bypass surgery during their teenage years. The scientists believe the neural tube defects occur because the body cannot absorb nutrients properly after bypass surgery. Medical professionals know that one of the consequences of gastric bypass surgery is malabsorbtion, which can cause a number of deficiencies, including not enough folic acid. Folic acid is a vital element during pregnancy in preventing neural tube defects in the developing baby. Dr. Farmer explained that daily folate replacement can make up for this deficiency. Unfortunately, a significant number of adolescents do not adhere to (comply with) medication regimens - they forget to take the tablets. As adolescents are more likely to become pregnant after gastric bypass surgery, this situation is especially critical. The study report is called "Neural Tube Defects: An Unforseen Consequence of Gastric Bypass Surgery in Young Female Patients?" Source: American Academy of Pediatrics

Summary: The malabsorption of folate, poor compliance with nutritional supplements and a higher risk of unintended pregnancies places young women at an increased risk for pregnancies complicated with neural tube defects. Although obesity is epidemic, gastric bypass surgery should be avoided in adolescent women given the potential increased risk of fetal neural tube defects," Farmer said. "If gastric bypass is performed on an adolescent female, great efforts must be made to minimize the risks of both unintended pregnancies and nutritional deficiencies. This should include extensive pre-surgery counseling and frequent post-operative follow-up, as well as consideration of highly efficacious contraceptives such as an intrauterine device. Reaction: GBP makes the stomach smaller and allows food to bypass part of the small intestine. You will feel full more quickly than when your stomach was its original size, which reduces the amount of food you eat and thus the calories consumed. Bypassing part of the intestine also results in fewer calories being absorbed. So in this statement, it shows that the consequence of having this procedure may lead you to malabsorption of nutrients and when you become pregnant your baby will have some defects due to lack of adequate nutrients. So when you are a lady and planning to have a surgery, better thinks twice.

Drug name

Dosage/Route

Mechanism of action

Indication

Contraindicati on

Side Effect

Nursing Responsibility

Generic Name AMPICILLIN Brand Name: Omnipen; Polycillin; Principen

Tablets: 250mg; 500mg. Oral suspension: 100 mg/mL; 125 mg/5mL; 250 mg/5mL.

Belonging to the penicillin group of beta-lactam antibiotics, ampicillin is able to penetrate Grampositive and some Gramnegative bacteria. It differs from penicillin only by the presence of an amino group. That amino group helps the drug penetrate the outer membrane of gram-negative bacteria. Ampicillin acts as a competitive inhibitor of the enzyme transpeptidae.Tr anspeptidase is needed by bacteria to make their cell walls.[1] It inhibits the third and final stage of bacterial cell wall synthesis, which ultimately leads to cell lysis.

Ampicillin is closely related to amoxicillin, another type of penicillin, and both are used to treat urinary tract infections, otitis media, uncomplicated communityacquired pneumonia, Haemophilus influenzae, salmonellosis and Listeria meningitis. It is used with flucloxacillin in the combination antibiotic co fluampicil for empiric treatment of cellulitis; providing cover against Group A streptococcal infection whilst the flucloxacillin acts against the Staphylococcus aureus bacterium.

The use of Ampicillin is contraindicate d in individuals with a history of hypersensiti vity reactions to any of the penicillins.

Allergic reaction: hives; difficultyin breathing; swelling of your face, lips, tongue, or throat. Serious Side effects: fever, sore throat, and headache with a severe blistering, peeling, and red skin rash; diarrhea that is watery or bloody; fever, chills, body aches, flu symptoms; easy bruising or bleeding, unusual weakness; urinating less than usual, unusual thoughts or behaviour;

Do not give IM at the same site atrophy can occur. Administer oral drugs on an empty stomach, 1 hr before or or 2 hr after meals with full glass of water, do not give with fruit juice or soft drinks

Drug name Generic Name:

Dosage/Route
Hypertension PO: ADULTS: Initially, 0.1

Mechanism of action
Clonidine reduces

Indication
Clonidine is used for the treatment of

Contraindication
Clonidine hydrochloride

Side Effect
Dry mouth

Nursing Responsibility
Monitor intake and output

Clonidine Brand Name:

Catapin, Catapres, Dixarit, Duraclon, and Melzin. Clonidine is classified as an anti-adrenergic, symphatholytic, and antihypertensive.

mg two times a day. Increase by 0.1-0.2 mg every 2 to 4 days. MAINTENANCE: 0.21.2 mg per day in two to four divided doses up to a maximum of 2.4 mg/day. CHILDREN: 5-25 mcg/kg/day in divided doses every 6 hours; increase at 5- to 7-day intervals. Maximum: 0.9 mg/day. TRANSDERMAL: ADULTS, ELDERLY: System delivering 0.1 mg/24 hours up to 0.6 mg/24 hours every 7 days. Usual Elderly Dosage PO: Initially, 0.1 mg at bedtime. may increase gradually. ADHD PO: CHILDREN: Initially 0.05 mg per day. May increase by 0.05 mg per day every 3-7 days. Maximum: 0.3-0.4 mg per day. Severe Pain Epidural: ADULTS, ELDERLY: 30-40 mcg per hour. CHILDREN: Initially 0.5 mcg/kg/hour not to exceed adult dose.

peripheral resistance; decreases blood pressure and heart rate. Epidurally administered clonidine prevents pain signal transmission to the brain and produces analgesia at pre- and post-alphaadrenergic receptors in the spinal cord.

hypertension alone or in combination with other antihypertensive agents. It is also used in the treatment of severe pain. Clonidine may also be used in the diagnosis of pheochromocytoma, prevention of migraine headaches, treatment of dysmenorrhea or menopausal flushing, opioid withdrawal, and attention deficit hyperactivity disorder (ADHD).

tablets should not o be used in patients o with known o hypersensitivity to o clonidine

o o o o o o o o o o o o o o o

Drowsiness Dizziness Sedation Constipation Depression Swelling of feet Loss of appetite Decreased sexual ability Itching of the eyes Dizziness Nausea Vomiting Nervousness Itching Red skin Darkening of skin Nightmares Vivid dreams Cold feeling in the fingers or toes

ratios and daily weight, and assess for edema daily, especially at beginning of therapy. Monitor blood pressure and pulse frequently during initial dosage adjustment and periodically throughout therapy. Report significant changes. Pain: Assess location, character, and intensity of pain prior to, frequently during first few days, and routinely throughout administration.